How Laws About NP Practice Evolve

Transcription

1 Nata-Lia/Shutterstock CHAPTER 3 STATE REGULATION OF NURSE PRACTITIONER PRACTICE Bartlett Learning, The law governing LLCnurse practitioner (NP) definition, Jones scope & Bartlett of practice, Learning, prescriptive authority, DISTRIBUTION and requirement of physician collaboration, NOT if any, FOR may SALE be enacted OR by DISTRIBUTION a state legislature LLC SALE OR in great detail or in general terms. Alternatively, the state legislature may give authority to a licensing board to make the rules and regulations that govern NPs. The state board that is likely to have the authority to make the rules regarding NPs is the board of nursing. In many states, the board of nursing makes the rules governing NP practice. In Jones some states, & Bartlett however, the Learning, board of medicine LLC has a role. See Appendix 3-A Jones for a & Bartlett Le state-by-state NOT list FOR of the SALE agencies OR that DISTRIBUTION regulate NPs. How Laws About NP Practice Evolve Jones State & Bartlett law takes two Learning, forms: statutes LLC and regulations (sometimes referred Jones to as & rules). Bartlett The Learning, LLC NOT FOR legislature SALE makes OR statutory DISTRIBUTION law, and state agencies, under the executive NOT FOR branch SALE of government, OR DISTRIBUTION make regulations. Regulations cannot contradict statutes but often expand upon the statutes to include more detail of government administration. When a member of the public wants to change a statute, the advocate must enlist the help of a state legislator, who can introduce a bill that will change the current statute. When a member Bartlett Learning, of the public LLC wants to change a regulation, the advocate Jones must & Bartlett either convince Learning, the state LLC agency SALE OR that DISTRIBUTION is responsible for the regulation to change NOT the regulation FOR SALE or convince OR DISTRIBUTION a legislator to introduce a bill that, if enacted, would override the regulation. When an agency decides to change a regulation, the agency writes a new regulation, publishes the regulation in an official state publication, and invites comments from interested parties. The agency may or may not make changes to the proposed regulation based on comments Jones received & Bartlett from interested Learning, parties. A LLC proposed regulation becomes a Jones final & Bartlett Le regulation law after NOT FOR SALE it has been OR published DISTRIBUTION in proposed form and comments NOT have been FOR SALE OR D reviewed. Final regulations are republished, in final form, in the state s register, an official publication of the state. 133 Jones &..

2 134 CHAPTER 3 State Regulation of Nurse Practitioner Practice What Is Regulated? Much of the state law governing NPs appears in regulations; some law is statutory. The practice issues that come under state regulation are: Requirements for licensure Scope of practice Prescriptive authority Jones & Requirement Bartlett of Learning, collaboration LLC or supervision NOT FOR Basis SALE for license OR DISTRIBUTION suspension, revocation, or nonrenewal Reimbursement under Medicaid Reimbursement by indemnity insurers Requirements of educational programs Standards of practice SALE OR Licensure DISTRIBUTION Requirements State law governs the requirements for holding a professional license in the state. All states require NPs to hold state licenses as registered nurses (RNs). Forty states require NPs to have master s degrees. Forty-five states require NPs to have obtained national certification. Appendix 3-B lists state-by-state requirements for holding and maintaining an NP license. Basis NOT for Loss FOR of SALE License OR DISTRIBUTION State law, usually a regulation, specifies the criteria under which an NP s license may be revoked, suspended, or not renewed. Examples of some state laws follow. North Carolina makes continuation of practice contingent upon following the rules of physician supervision. Rhode Island s law does not address physician collaboration or supervision but is concerned with practice-related safety issues. NOT FOR More SALE specific OR than DISTRIBUTION most, North Carolina s law enforces the requirement NOT FOR of SALE an NP to OR practice DISTRIBUTION under physician supervision:... [A]ction may be taken... if one or more of the following is found: That the nurse practitioner held himself or herself out or permitted another to represent LLC the nurse practitioner as a licensed Jones physician; & Bartlett Learning, That the nurse practitioner has engaged NOT or FOR attempted SALE to engage OR in DISTRIBUTION the performance of medical acts other than according to the collaborative practice agreement. Citation: N.C. Admin. Code tit. 21, r In Rhode Island, grounds for revocation/suspension include: a. Guilty of fraud or deceit in procuring or attempting to procure a license to practice nursing b. Guilty of a crime of gross immorality c. Unfit or incompetent by reason of negligence or habits d. Habitually intemperate or... addicted to one of the habit-forming drugs Jones & Bartlett e. Mentally Learning, incompetentllc f. Guilty of unprofessional conduct which includes: i. Abandonment of a patient ii. Willfully making and filing false reports or records in the practice of nursing..

3 What Is Regulated? 135 iii. Willful omission to file reports or record nursing records or reports as required by law Jones iv. Failure & to Bartlett furnish appropriate Learning, details LLC of client s nursing needs to succeeding FOR nurse SALE legally OR qualified DISTRIBUTION to provide continuing nursing services NOT to a FOR SALE OR D NOT client v. Willful disregard of standards and failure to maintain standards of the nursing profession vi. Failure to comply with the provisions of RIGL (c)(2) of the General Learning, Laws, as an Advanced LLC Practice Registered Nurse Jones & Bartlett NOT FOR SALE g. Guilty OR of DISTRIBUTION willfully or repeatedly violating any of the provisions NOT FOR of the SALE act and/or OR DISTRIBUTION the rules and regulations adopted thereunder. Citation: R.I. Nursing Rules

4 APPENDIX 3-A State-by-State List of Agencies That Regulate Nurse Practitioners ALABAMA: State Board of Medical KENTUCKY: Board of Nursing Examiners and Board of Nursing LOUISIANA: Board of Nursing ALASKA: Board of Nursing MAINE: Board of Nursing ARIZONA: NOT Board FOR of Nursing MARYLAND: Board of Nursing ARKANSAS: Board of Nursing MASSACHUSETTS: Board of CALIFORNIA: Board of Registered Registration in Nursing Nursing MICHIGAN: Board of Nursing COLORADO: Board of Nursing MINNESOTA: NOT Board FOR of SALE Nursing OR DISTRIBUTION CONNECTICUT: Board of Examiners MISSISSIPPI: Board of Nursing for Nursing MISSOURI: Board of Nursing DELAWARE: Board of Nursing and Board of Medical Licensure and Discipline MONTANA: Board of Nursing SALE OR DISTRICT DISTRIBUTION OF COLUMBIA: Board of NOT NEBRASKA: FOR SALE Board OR of DISTRIBUTION Advanced Practice Nursing Registered Nurses FLORIDA: Board of Nursing and Board of NEVADA: Board of Nursing Medicine NEW HAMPSHIRE: Board of Nursing GEORGIA: Jones Board of & Nursing NEW JERSEY: Board of Nursing HAWAII: NOT Board FOR of Nursing NEW MEXICO: Board of Nursing IDAHO: Board of Nursing NEW YORK: Board of Nursing ILLINOIS: Board of Nursing NORTH CAROLINA: Board of Nursing Jones INDIANA: & Bartlett Board Learning, of Nursing LLC and Medical Jones Board& NOT FOR IOWA: SALE Board OR of Nursing DISTRIBUTION NORTH DAKOTA: NOT FOR Board SALE of Nursing OR DISTRIBUTION KANSAS: Board of Nursing OHIO: Board of Nursing 136 Jones &..

5 Appendix 3-A 137 OKLAHOMA: Board of Nursing TEXAS: Board of Nursing OREGON: Jones Board of & Nursing UTAH: Board of Nursing PENNSYLVANIA: Board of Nursing VERMONT: Board of Nursing RHODE ISLAND: Board of Nurse Registration and Nursing Education Jones SOUTH & Bartlett CAROLINA: Learning, Board of LLC Nursing NOT FOR SOUTH SALE DAKOTA: OR DISTRIBUTION Board of Nursing and Board of Medical and Osteopathic Examiners TENNESSEE: Board of Nursing VIRGINIA: Board of Nursing and Board of Medicine WASHINGTON: Nursing Commission WEST VIRGINIA: NOT FOR Board SALE of Examiners OR DISTRIBUTION for Registered Professional Nurses WISCONSIN: Board of Nursing WYOMING: Board of Nursing..

6 APPENDIX 3-B State-by-State Nurse Practitioner Qualifications Required by Law All qualifications specified are for initial licensure to practice. For requirements for renewal, check the website of your state s board of nursing. Alabama Alabama RN license Graduation from an organized program of study and clinical experience beyond the basic educational preparation as a registered nurse that prepares nurse practitioners and is Jones & Bartlett recognized Learning, by the Board LLC of Nursing and/or the appropriate Jones specialty & certifying Bartlett agency Learning, LLC Master s degree or higher in advanced practice nursing from an accredited program NOT FOR SALE recognized OR DISTRIBUTION by the Board Certification as a certified registered nurse practitioner from a national certifying agency recognized by the Board of Nursing in the clinical specialty consistent with educational preparation and appropriate to the area of practice Citation: Jones Ala. & Bartlett Admin. Code Learning, r. 610-X LLC Alaska Requirements for initial authority to practice: A formal Jones accredited & Bartlett graduate Learning, educational LLC course of study in nursing that is Jones a & Bartlett Le NOT minimum FOR of one SALE academic OR year DISTRIBUTION in length; prepares registered nurses to NOT perform an expanded role in the delivery of health care; includes a combination of FOR SALE OR D classroom instruction and a minimum of 500 separate, non-duplicated hours of supervised clinical practice; and if completed on or after January 1, 1998, has distinct course offerings of three graduate credits or more in advanced pathophysiology, Learning, advanced pharmacotherapeutics, LLC and advanced Jones physical & assessment Jones & Bartlett NOT FOR SALE Alaska OR RN DISTRIBUTION license Certification as a nurse practitioner by a national certifying agency in the population focus of nursing for which the applicant was educated 138 Jones &..

7 Appendix 3-B 139 Requirement to maintain authority to practice: 30 Jones contact hours & Bartlett of continuing Learning, education LLC in the population focus of the nurse Jones & Bartlett Le practitioner every two years Citation: Alaska Admin. Code tit. 12, Arizona A. An applicant for certification as an advanced practice registered nurse, shall: NOT FOR SALE 1. Hold OR a DISTRIBUTION current Arizona registered nurse (RN) license NOT in good FOR standing SALE or OR an RN DISTRIBUTION license in good standing from a compact party state with multistate privileges 2. Submit a verified application to the Board on a form provided by the Board that provides a. Full legal name and all former names b. Current mailing address and telephone number c. Place and date of birth d. RN license number, application for RN license, or copy of a multistate compact RN license e. Social security number Jones f. Current & Bartlett address Learning, LLC g. Educational background... NOT h. FOR Role and SALE population OR DISTRIBUTION focus... i. Current employer or practice setting... j. Evidence of national certification or recertification as an advanced practice registered nurse in the role and population focus, if applicable, Jones & Bartlett of Learning, the application LLC... [additional requirements omitted] Jones & Citation: Ariz. Admin. Code NOT R (1) FOR SALE and OR (2). DISTRIBUTION A. The Board shall authorize an RNP to prescribe and dispense (P&D) drugs and devices within the RNP s population focus only if the RNP does all of the following: 1. Obtains authorization by the Board to practice as a registered nurse practitioner; 2. Applies for prescribing and dispensing privileges on the application for registered nurse practitioner certification; 3. Submits a completed verified application NOT FOR on a SALE form provided OR DISTRIBUTION by the Board that contains all of the following information: a. Name, address, address and home telephone number; b. Arizona registered nurse license number, or copy of compact license; Jones c. Nurse & practitioner Bartlett population Learning, focus; LLC d. Nurse practitioner certification number issued by the Board; and NOT e. FOR Business SALE address OR and DISTRIBUTION telephone number; 4. Submits evidence of a minimum of 45 contact hours of education within the three years immediately preceding the application, covering one or both of the following topics consistent with the population focus of education and certification: Jones & Bartlett a. Pharmacology, Learning, LLC or b. Clinical management of drug therapy, and 5. Submits the required fee. Citation: Ariz. Admin. Code R

8 140 CHAPTER 3 State Regulation of Nurse Practitioner Practice Arkansas Evidence of education approved by the board National certification approved by the board in the advanced practice registered nurse role and population foci appropriate to the educational preparation Citation: Ark. Code Ann NOT FOR California RN license in California One of the following: 1. Successful completion of a program of study that conforms to the board standards; or Bartlett Learning, 2. Certification LLC by a national or state organization Jones & Bartlett whose standards Learning, are equivalent LLCto those set forth in Section 1484; or 3. A nurse who has not completed a nurse practitioner program which meets board standards as specified in Section 1484, shall provide: A. Documentation of remediation of areas of deficiency in course content and/or clinical experience, and Jones B. Verification & Bartlett by a nurse Learning, practitioner LLC and by a physician who meet the Jones & Bartlett Le requirements for faculty members specified in Section 1484(c), of clinical competence in the delivery of primary health care Citation: Cal. Code Regs Colorado NOT FOR SALE Completion OR DISTRIBUTION of an appropriate graduate degree as determined NOT FOR by the SALE board OR DISTRIBUTION National certification from a nationally recognized agency, as determined by the board, in the appropriate role and population focus For prescriptive authority, in addition to the two conditions above: Bartlett Learning, Satisfactory LLC completion of specific educational Jones requirements & Bartlett in Learning, the use of controlled substances and prescription NOT drugs, as FOR established SALE by OR the board, DISTRIBUTION either as LLC part of a degree program or in addition to a degree program Professional liability insurance A signed attestation stating that at least three years of combined clinical work experience as a professional nurse or as an advanced practice nurse have been completed Citation: Colo. Rev. Code Ann and Connecticut RN license Jones & Bartlett Certification Learning, as a nurse LLC practitioner from a national certifying Jones body & approved Bartlett by Learning, LLC NOT FOR SALE the Board OR DISTRIBUTION 30 hours of education in pharmacology for advanced nursing practice..

9 Appendix 3-B 141 Graduate degree in nursing or in a related field recognized for certification as a nurse practitioner from an accredited program recognized by the Board Citation: Conn. Gen. Stat. Ann a(a). Delaware RN license in Delaware or a compact state Jones & Bartlett Possess a Learning, master s degree LLC or post-basic program certificate Jones in a clinical & Bartlett nursing Learning, LLC NOT FOR SALE specialty OR with DISTRIBUTION national certification that is recognized NOT by the FOR Board Citation: Del. Admin. Code tit. 24, 1902(b). District of Columbia RN license Submit evidence of national certification or recertification, as applicable, by the ANCC or other national certifying body approved by the Board. Furnish proof... that the applicant has successfully completed a post-basic nursing education program applicable to the area of practice approved by the Board Jones or accredited & Bartlett by a nationally Learning, recognized LLC body accepted by the Board Jones and & Bartlett Le NOT which FOR is relevant SALE to the OR nurse DISTRIBUTION practitioner s area of practice. Receive a passing score on the national certification examination, offered by the ANCC or any other nationally recognized body accepted by the Board. Citation: D.C. Municipal Rules tit. 17, and Florida RN license Certification by an appropriate specialty board Graduation from a program leading to a master s degree in a nursing clinical Bartlett Learning, specialty LLCarea with preparation in specialized Jones practitioner & Bartlett skills. Learning, LLC NOT FOR Citation: SALE Fla. OR Stat. DISTRIBUTION ch (1). Applicant shall submit proof of national advanced practice certification from an approved nursing specialty board Pursuant to Section , F.S., all ARNP s shall carry malpractice insurance or Jones demonstrate & Bartlett proof of financial Learning, responsibility LLC Citation: Fla. Admin. Code ch. 64B (2)&(5). Georgia Jones & Bartlett RN license Learning, GeorgiaLLC NOT FOR SALE Official OR transcript DISTRIBUTION which verifies graduation with a master s NOT or FOR higher SALE degree OR DISTRIBUTION in nursing for the respective nurse practitioner specialty or a graduate level..

10 142 CHAPTER 3 State Regulation of Nurse Practitioner Practice post-master s certificate in an advanced practice registered nurse practitioner specialty and evidence of advanced pharmacology within the curriculum or as a separate Jones course, & Bartlett advanced Learning, physical assessment, LLC and pathophysiology NOT Verification FOR of SALE current OR national DISTRIBUTION certification from the respective Board- recognized certifying organization The applicant must document one of the following within the four (4) years immediately preceding the date of current application: a. 500 hours of practice as an advanced practice registered nurse; Jones & Bartlett b. graduation Learning, from a LLC nursing education program or a graduate Jones level & Bartlett post- Learning, LLC NOT FOR SALE master s OR DISTRIBUTION certificate in an advanced practice registered NOT nurse FOR practitioner specialty; c. completion of a Georgia Board-approved advanced practice registered nurse reentry/refresher program. Citation: Ga. Comp. Jones R. & Regs. Bartlett r (3) Learning, and LLC (4). Hawaii A current, unencumbered RN license in the state of Hawaii Unencumbered RN license in all other states where licensed An Jones unencumbered & Bartlett license Learning, as an advanced LLC practice registered nurse or similar NOT designation FOR in SALE all other OR states DISTRIBUTION in which the nurse has a current and active NOT license FOR SALE OR D as an advanced practice registered nurse Completed an accredited graduate-level education program preparing the nurse for one of the four recognized advanced practice registered nurse roles A current, unencumbered certification of having passed a national certification Jones & Bartlett examination Learning, that measures LLCroles and population-focused Jones competencies & Bartlett and is Learning, LLC NOT FOR SALE recognized OR DISTRIBUTION by the board Maintained continued competencies through recertification in role and populationfocused competencies through a national certification program recognized by the board Acquired advanced clinical knowledge and skills preparing the nurse to provide Bartlett Learning, direct LLC care to patients through a significant Jones educational & Bartlett and practical Learning, concentration on the direct care of patients LLC Demonstrated a greater breadth of knowledge, a greater synthesis of data, greater complexity of skills and interventions, and greater role autonomy than demonstrated by a registered nurse Been educationally prepared to assume responsibility and accountability for health Jones promotion & Bartlett and maintenance Learning, and to LLC assess, diagnose, and manage patient Jones & Bartlett Le NOT problems FOR through SALE the use OR and DISTRIBUTION prescription of pharmacologic and nonpharmacologic interventions Acquired clinical experience of sufficient depth and breadth to reflect the intended license Citation: Haw. Rev. Stat. Ann a. NOT FOR SALE... [T]he OR DISTRIBUTION applicant for recognition as an advanced practice NOT registered FOR SALE nurse shall OR DISTRIBUTION provide proof of:..

11 Appendix 3-B 143 Documentation relating to any disciplinary action ordered by or pending before any board of nursing in any state or jurisdiction of the United States; and Documentation Jones & Bartlett... regarding Learning, any criminal LLC conviction... within the past twenty Jones & Bartlett Le NOT years, in FOR which SALE the conviction OR DISTRIBUTION was not annulled or expunged.... Citation: Haw. Admin. R The requirements for prescriptive authority are as follows: Jones & Bartlett Completed Learning, application LLC for prescriptive authority for controlled Jones or noncontrolled & NOT FOR SALE substances OR DISTRIBUTION provided by the board and submitted with NOT all appropriate FOR SALE documents OR DISTRIBUTION and required feeds Proof of a current, unencumbered license as a RN Proof of a current, unencumbered recognition or license as an advanced practice registered nurse Bartlett Learning, Proof LLC of successful completion of an accredited Jones graduate-level & Bartlett Learning, nursing program LLC with a significant educational and practical NOT FOR concentration SALE on OR the DISTRIBUTION direct care of patients, recognized by the board, leading to a master s degree Proof of successful completion of at least 30 contact hours, as part of a master s degree program from an accredited, board-recognized college or university, of advanced pharmacology education, including advanced pharmacotherapeutics that Jones is integrated & Bartlett into the curriculum, Learning, within LLCthe three-year time period immediately FOR preceding SALE the date OR of DISTRIBUTION application Jones & Bartlett Le NOT Payment of a fee Citation: Haw. Admin. R Idaho RN license in Idaho Completion of an approved advanced practice registered nursing education program that meets the board requirements for the role of advanced nursing practice for which the applicant is seeking licensure Bartlett Learning, Passed LLC a qualifying examination recognized Jones by the & Bartlett board and have Learning, current certification from a national organization recognized by the board LLC Be of sufficiently sound physical and mental health as will not impair or interfere with the ability to practice nursing Citation: Idaho Code To prescribe Jones pharmacologic & Bartlett and Learning, non-pharmacologic LLC agents: Currently licensed as an advanced practice registered nurse in Idaho Evidence of completion of thirty (30) contact hours of post-basic education in pharmacotherapeutics obtained as part of study within a formal educational program or continuing education program, which are related to the applicant s Jones & Bartlett advanced Learning, practice category LLCscope of practice Submit a completed, notarized application form provided by the Board Remit fees prescribed in Section 901 Citation: Idaho Admin. Code (a)...

12 144 CHAPTER 3 State Regulation of Nurse Practitioner Practice Illinois RN license Successful completion of requirements needed to practice as, and hold a current, national certification as a... nurse practitioner... from the appropriate national certifying body as determined by rule of the Department Obtained a graduate degree appropriate for national certification in clinical Jones & Bartlett advanced Learning, practice nursing LLCspecialty or a graduate degree Jones or post-master s & Bartlett certificate from a graduate level program in a clinical advanced practice nursing Learning, LLC specialty Have not violated the provisions of this Act concerning the grounds for disciplinary action Submit to the criminal history records check... Citation: Jones 225 & Ill. Bartlett Comp. Stat. Learning, 65/65-5(b). LLC Indiana RN license in Indiana Completed Jones a & graduate Bartlett program Learning, offered by LLC a college or university accredited Jones by & Bartlett Le the Commission on Recognition of Postsecondary Accreditation which prepares the registered nurse to practice as a nurse practitioner and meets the requirements of section 6 of this rule; or Completed a certificate program offered by a college or university accredited by the Commission on Recognition of Postsecondary Accreditation which prepares Jones & Bartlett the registered Learning, nurse to LLC practice as a nurse practitioner and Jones meets the & requirements of section 6 of this rule. Nurse practitioners who complete a certificate program must be certified and maintain certification as a nurse practitioner by a national organization which requires a national certifying examination Citation: Ind. Admin. Code tit. 848, r Bartlett Learning, To prescribe: LLC Submits an application with the required NOT fee FOR Active, unrestricted registered nurse license Proof of having met the requirements of all applicable laws for practice as an advanced practice nurse in the state of Indiana Baccalaureate or higher degree nursing Completion of a graduate level pharmacology course consisting of at least two NOT semester FOR hours SALE of academic OR DISTRIBUTION credit from a college accredited by the Commission on Recognition of Postsecondary Accreditation, or Completion of 30 hours of continuing education in the past two years, including a minimum of at least eight actual contact hours of pharmacology Jones & Bartlett Submits Learning, proof of collaboration LLC with a licensed practitioner Jones in the form & Bartlett of a writ-learningten practice agreement that sets forth the manner in which the advanced prac- LLC NOT FOR SALE tice nurse OR DISTRIBUTION and licensed practitioner will cooperate, coordinate, NOT FOR and consult SALE with OR DISTRIBUTION each other in the provision of health care to patients. Citation: Ind. Admin. Code tit. 848, r

13 Appendix 3-B 145 Iowa RN license in Iowa or from another state that is recognized for licensure in Iowa Graduation from a program leading to a master s degree in a nursing clinical specialty area with preparation in specialized practitioner skills as approved by the board; or satisfactory completion of a formal advanced practice educational program of study in a nursing specialty area approved by the board and appropriate clinical Learning, experience LLC as approved by the board Jones & Bartlett Copy of the time-dated, advanced level certification by appropriate national certifying body evidencing that the applicant holds current certification in good standing Copy of official transcript directly from formal advanced practice educational program maintaining the records necessary to document that all requirements Bartlett Learning, have LLC been met in one of the specialty areas Jones of nursing & Bartlett practice Learning, LLC Citation: Iowa NOT Admin. FOR Code SALE r (4) OR DISTRIBUTION and (5). Kansas Advanced Jones practice & Bartlett registered Learning, nursing is based LLC on knowledge and skills acquired in NOT basic nursing FOR SALE education, OR licensure DISTRIBUTION as a registered nurse and graduation NOT from or FOR SALE OR D completion of a master s or higher degree in one of the advanced practice registered nurse roles approved by the board of nursing. Citation: Kan. Stat (c) (2). Jones & Bartlett Completion Learning, of a formal, LLC post-basic nursing education program Jones located & Bartlett or Learning, LLC NOT FOR SALE offered OR in DISTRIBUTION Kansas, approved by the board and that prepares NOT the FOR nurse SALE to function OR DISTRIBUTION in the advanced role for which application is made; or Completion of a formal, post-basic nursing education that is not located or offered in Kansas but is determined by the board to meet the standards for program approval established by K.A.R through ; or Bartlett Learning, Completion LLC of a formal, post-basic nursing Jones education & Bartlett program Learning, that could be LLC no longer in existence but is determined NOT by FOR the board SALE to meet OR standards DISTRIBUTION at least as stringent as those required for program approval by the board at the time of graduation; or Hold a current license to practice as an advanced practice registered nurse in the role for which application is made and that meets the following criteria: was issued Jones by a nursing & Bartlett licensing Learning, authority of LLC another jurisdiction; and required NOT completion FOR of SALE a program OR meeting DISTRIBUTION standards equal to or greater than those NOT established by K.A.R through ; or FOR SALE OR D Completion of a formal educational program of post-basic study and clinical experience that can be demonstrated by the applicant to have sufficiently prepared the applicant for practice in the role of advanced practice for which application Jones & Bartlett is madelearning, LLC..

14 146 CHAPTER 3 State Regulation of Nurse Practitioner Practice Each applicant for a license as an advanced practice registered nurse in a role other than anesthesia or midwifery shall meet one of the following requirements: Jones & NOT 1. Have FOR met one SALE of the OR requirements DISTRIBUTION of subsection (a) before July 1, 1994; 2. If none of the requirements in subsection (a) have been met before July 1, 1994, meet one of the requirements of subsection (a) and hold a baccalaureate or higher degree in nursing; or 3. If none of the requirements in subsection (a) have been met before July 1, 2002, Jones & Bartlett meet Learning, one of the requirements LLC of subsection (a) and hold Jones a master s & Bartlett or higher Learning, LLC NOT FOR SALE degree OR DISTRIBUTION in a clinical area of nursing A license may be granted if an individual has been certified by a national nursing organization whose certification standards have been approved by the board as equal to or greater than the corresponding standards established by the board for obtaining a license to practice as an advanced practice registered nurse Bartlett Learning, Completion LLC of 3 college hours each in Jones advanced & pharmacology, Bartlett Learning, advanced pathophysiology, and advanced health assessment NOT FOR or their SALE equivalents OR DISTRIBUTION LLC If an applicant for a certificate of qualification as an advanced registered nurse practitioner has not gained 1000 hours of advanced nursing practice during the five years preceding the date of application, [they] shall be required to successfully complete a refresher course as defined by the board. Citation: Kan. Admin. Regs Kentucky RN licensure or holding the privilege to practice as a registered nurse in this Jones & Bartlett state and Learning, maintain current LLCcertification by the appropriate Jones national & organization NOT FOR SALE or agency OR DISTRIBUTION recognized by the board Completion of an organized post-basic program of study and clinical experience acceptable to the board Certification by a national established organization or agency recognized by the board Bartlett Learning, Facility LLC with English language Citation: NOT Ky. FOR Rev. SALE Stat. Ann. OR DISTRIBUTION (1)&(2). Louisiana RN Jones license in & Louisiana Bartlett and Learning, there are no LLC grounds for disciplinary proceedings NOT Completion FOR of SALE a minimum OR of DISTRIBUTION a graduate degree with a concentration in NOT the re-fospective advanced practice nursing role and population focus or completion of SALE OR D a post master s concentration in the respective advanced practice nursing role and population focus from a program accredited by a nursing or nursing related accrediting body that is... approved by the board Jones & Bartlett Submission Learning, of evidence LLC of current certification in the respective Jones advanced & Bartlett practice nursing OR DISTRIBUTION role and population focus by a nationally NOT recognized FOR certifying Learning, LLC NOT FOR SALE body approved by the board. Citation: La. Admin. Code tit. 46, XLVII.4507(A)(1)...

15 Appendix 3-B 147 To prescribe: Unencumbered, Jones & Bartlett unrestricted, Learning, and valid RN LLC licensure with no pending disciplinary proceedings APRN licensure Evidence of 500 hours of practice as a licensed ARNP or APRN applicant within 1 year in the clinical specialty for which applicant was educationally prepared immediately prior to applying for prescriptive and distributing authority Jones & Bartlett Minimum Learning, of 45 contact LLC hours of education (three credit Jones hour academic & Bartlett course) Learning, LLC in advanced pharmacotherapeutics Minimum of 45 contact hours (three credit hour academic course) in physiology/pathophysiology Collaborative practice agreement with one or more licensed collaborating physicians Each year, six contact hours of continuing Jones education & Bartlett in pharmacotherapeutics Learning, LLC Maine Citation: NOT La. FOR Admin. SALE Code OR tit. 46, DISTRIBUTION XLVII RN Jones license in & Maine Successfully completed a formal education program that is acceptable to the NOT board in FOR an advanced SALE nursing OR DISTRIBUTION specialty area Holds a current certification credential for advanced nursing from a national certifying body whose certification program is acceptable to the board Citation: Code Me. R. 32 M.R.S.A A. A registered professional nurse who is approved by the Board to practice as an advanced practice registered nurse prior to January 1, 1996 is considered to have met the requirements of 32 M.R.S.A. Section 2201-A(2) and (3) regarding education and certification As of January 1, 2006, an applicant for initial approval as an advanced practice registered nurse in Maine must hold a master s degree with preparation the specialty area for which application is made Citation: Code Me. R (Section 1)(2). Submit evidence of current certification in the specialty area of practice, if applicable Submit Jones evidence & Bartlett of a minimum Learning, of 1500 hours LLCof practice in an expanded specialty nursing role within 5 years preceding application, or has completed a Jones & Bartlett Le nurse practitioner program within 5 years preceding application. If more than 5 years have elapsed since completion of an advanced practice registered nurse program and the applicant does not meet the practice requirement of 1500 hours, the applicant shall complete 500 hours of clinical practice supervised by a Jones & Bartlett physician Learning, or nurse practitioner LLC in the same specialty area Jones of practice & Submit evidence of satisfactory completion of 45 contact hours (or 3 credits) of pharmacology... Citation: Code Me. R (Section 2)(2)...

16 148 CHAPTER 3 State Regulation of Nurse Practitioner Practice 1. Requirements for prescriptive authority for certified nurse practitioners and certified nurse-midwives A. Jones If the applicant & Bartlett has not Learning, prescribed drugs LLCwithin the past 2 years, the applicant FOR shall SALE provide evidence OR DISTRIBUTION of satisfactory completion of 15 contact NOT hours of FOR SALE OR D Jones & Bartlett Le NOT pharmacology within the 2 years prior to applying for approval to practice. B. If the applicant has not prescribed drugs within the past 5 years, the applicant shall provide evidence of satisfactory completion of 45 contact hours (or 3 credits) of pharmacology within the 2 years prior to applying for approval to practice. 2. Provision for certified nurse practitioners and certified nurse-midwives with prescriptive authority in other U.S. jurisdictions A. A certified nurse practitioner or certified nurse-midwife who holds prescriptive authority in another U.S. jurisdiction must submit evidence of the following: 1. Minimum of 200 hours of practice in an expanded specialty role within the preceding 2 years contact hours (or 3 credits) of pharmacology equivalent to the requirements set forth in Section 64(3)(A) and (B). B. If the applicant has not prescribed drugs within the past 2 years, the applicant shall provide evidence of satisfactory completion of 15 contact hours of pharmacology within the 2 years prior to applying for approval to practice. C. If Jones the applicant & Bartlett has not prescribed Learning, drugs LLC within the past 5 years, the applicant shall provide evidence of satisfactory completion of 45 contact hours (or 3 credits) of pharmacology within the 2 years prior to applying for approval to practice. Citation: Code Me. R (Section 6). Maryland NOT FOR SALE Hold OR a current DISTRIBUTION RN license in good standing in Maryland NOT or a FOR compact SALE state OR DISTRIBUTION Submit to the Board documentation that the applicant has graduated from a Board-approved educational program for nurse practitioners Submit to the Board documentation of certification as a nurse practitioner by a national certifying body recognized by the Board Citation: Md. Regs. Code Massachusetts Valid RN license in Massachusetts in good standing Good Jones moral & character Bartlett as required Learning, by MGL LLC c. 112, 74 and as established by Jones & Bartlett Le Board policy Graduation from a graduate degree program designed to prepare the graduate for practice as a certified nurse practitioner that is approved by a national accrediting organization for academic programs acceptable to the Board Successful completion of, at minimum, core content at the graduate Jones & Bartlett level in advanced Learning, assessment, LLC advanced pathophysiology Jones and advanced & NOT FOR SALE pharmaco OR DISTRIBUTION therapeutics Current certified nurse practitioner certification granted by Board-recognized certifying organization Citation: Code Mass. Regs. tit. 244, 4.05(3)...

17 Appendix 3-B 149 Registered nurses who apply for initial authorization in advanced nursing practice shall furnish to the board documentation that they have received either a degree for preparation Jones & in Bartlett advanced Learning, nursing practice LLC from a graduate school approved Jones by & Bartlett Le a NOT national FOR accrediting SALE body OR acceptable DISTRIBUTION to the board, or have received a certificate of completion of an educational program in advanced nursing practice approved by a national accrediting body acceptable to the board. The applicant shall also submit to the board documentation of current certification in advanced nursing practice from a national professional or specialty certifying organization acceptable to the Learning, board. LLC Jones & Bartlett Citation: Mass. Ann. Laws ch. 112, 80B. Michigan Bartlett Learning, Current LLCand valid RN license in Michigan Meets the advanced practice certification NOT standards FOR SALE of one OR of the DISTRIBUTION certification organizations listed in Mich. Admin. Code R (3)(c) Citation: Mich. Admin. Code R (3). Minnesota Hold a current Minnesota professional nursing license or demonstrate eligibility for licensure as a registered nurse in this state Must not hold an encumbered license as a registered nurse in any state or Jones & Bartlett territorylearning, LLC NOT FOR SALE Have OR completed DISTRIBUTION a graduate level APRN program accredited NOT by FOR a nursing SALE or OR DISTRIBUTION nursing-related accrediting body that is recognized by the United States Secretary of Education or the Council for Higher Education Accreditation as acceptable to the board. The education must be in one of the four APRN roles for at least one population focus Bartlett Learning, Currently LLCcertified by a national certifying Jones body & recognized Bartlett by Learning, the board the LLC APRN role and population foci appropriate to educational preparation Citation: Minn. Stat. Ann (Subd. 1a). The board shall issue a license to an applicant who does not meet the education requirements in subdivision 1a, paragraph (c), clause (3), if the applicant: is recognized by the board to practice as an advanced practice registered nurse in this state on July 1, 2014; and meets the requirements under subdivision 1a, paragraph (c), clauses (1), (2), (4), (5), and (6) Citation: Minn. Stat. Ann (Subd. 1b)...

18 150 CHAPTER 3 State Regulation of Nurse Practitioner Practice Mississippi RN license Satisfactory completion of a formal post-basic educational program of at least one academic year, the primary purpose of which is to prepare nurses for advanced or specialized practice Graduation from a program leading to a master s or post-master s degree in Jones & Bartlett a nursing Learning, clinical specialty LLCarea with a preparation in specialized Jones practitioner & skills Certification by a board approved certifying body Citation: Miss. Nursing Practice Law (1). Missouri Current unencumbered RN license NOT in Missouri FOR or SALE a compact OR state DISTRIBUTION Evidence of completion of appropriate advanced nursing education program Current certification in [appropriate] advanced nursing clinical specialty area [from] a MSBN-approved nationally-recognized certifying body Evidence of satisfactory, active, up-to-date certification/recertification/maintenance and/or continuing education/competency status For prescribing: Completion of three graduate credit hours of pharmacology offered by an accredited college or university within the last 5 years prior to the date of application to the board Jones & Bartlett Evidence Learning, of a minimum LLC of 800 hours of clinical practice Jones in the advanced & Bartlett practice nursing OR DISTRIBUTION clinical specialty area within two years prior NOT to date FOR of application Learning, LLC NOT FOR SALE to the board For prescribing controlled substances: Completion of an advanced pharmacology course (45 units that shall include Bartlett Learning, preceptorial LLC experience in the prescription Jones of drugs, & Bartlett medicines, Learning, and therapeutic LLC devices with a qualified preceptor) Provide evidence of completion of at least 300 clock hours of preceptorial experience in the prescription of drugs, medicines, and therapeutic devices with a qualified preceptor Has had controlled substance prescriptive authority delegated in a collaborative Jones practice & agreement Bartlett under Learning, section , LLC RSMo, with a Missouri licensed NOT physician FOR who SALE has an unrestricted OR DISTRIBUTION federal Drug Enforcement Administration (DEA) number Citation: Mo. Code Regs. tit. 20, CSR (2)(B)...

19 Appendix 3-B 151 Montana A person licensed under this chapter who holds a certificate in a field of advanced practice registered nursing may practice in the specified field of advanced practice registered nursing upon approval by the board of an amendment to the person s license granting a certificate in a field of advanced practice registered nursing. The board shall grant a certificate in a field of advanced Jones & Bartlett practice Learning, registered nursing LLCto a person who submits written Jones verification & Bartlett of certification by a board-approved national certifying body appropriate to the specific Learning, LLC field of advanced practice registered nursing and who meets any other qualification requirements that the board prescribes. Citation: Mont. Code Ann (1). Bartlett Learning, Current LLCRN license in Montana or from Jones a compact & Bartlett state Learning, LLC The applicant shall request that an official NOT transcript, FOR SALE from an OR accredited DISTRIBUTION graduate-level education program, be sent to the board directly from the applicant s APRN program to verify the date of completion and degree conferred The applicant shall submit evidence of preceptorship (if not shown on transcript) The Jones applicant & shall Bartlett submit Learning, a copy of current LLC national certification in APRN Jones role & Bartlett Le NOT and population FOR SALE focus, congruent OR DISTRIBUTION with education preparation Citation: Mont. Admin. R Nebraska NOT FOR SALE RN license OR DISTRIBUTION in Nebraska or from an approved compact NOT state FOR Evidence of having successfully completed a graduate-level program in the clinical specialty area of nurse practitioner practice, which program is accredited by a national accrediting body Evidence of having successfully completed 30 contact hours of education in Bartlett Learning, pharmacotherapeutics LLC Proof of having passed an examination pertaining to the specific nurse practitioner role in nursing adopted or approved by the board with the approval of the department Citation: Neb. Rev. Stat (1). Nevada Hold an RN license in Nevada Within two years of applying for a license, completion of a program designed to prepare an advanced practice registered nurse that is: i. at least one academic year in length, which must include, without limitation, Jones & Bartlett didactic Learning, instruction LLC and clinical experience with a qualified Jones physician & Bartlett or advanced OR DISTRIBUTION practice registered nurse; Learning, LLC NOT FOR SALE ii. accredited or approved by an organization approved by the Board;..

20 152 CHAPTER 3 State Regulation of Nurse Practitioner Practice iii. includes advanced courses in the assessment of health of patients, pathophysiology, and preparation for practice as an advanced practice registered nurse; iv. Jones includes & a concentration Bartlett Learning, of courses for LLC preparation in a specific role or population FOR focus; Jones & Bartlett Le NOT v. includes clinical experience that requires the student to integrate the knowledge and skills that are taught in the program and emphasizes the specific role and population focus chosen by the student; and vi. includes training in making clinical decisions, including, but not limited to, Jones & Bartlett diagnosing Learning, health conditions LLC and appropriate care NOT FOR SALE If the OR above DISTRIBUTION academic and clinical training was not completed NOT FOR within SALE two years OR DISTRIBUTION of the application, then complete 1000 hours of practice, without the privilege of writing prescriptions, under the supervision of a qualified physician or advanced practice registered nurse. If previously licensed or certified as an advanced practice registered nurse in another LLC state or jurisdiction, have maintained Jones the licensure & Bartlett or certification Learning, good LLC Bartlett Learning, standing and complied with the requirements NOT FOR for continuing SALE OR education DISTRIBUTION of that state or jurisdiction If the applicant completes a program designed to prepare an advanced practice registered nurse on or after July 1, 1992, but before June 1, 2005: 1. Be Jones certified & as Bartlett an advanced Learning, practice registered LLC nurse by a nationally recognized NOT certification FOR agency; SALE and OR DISTRIBUTION 2. Hold a bachelor s degree in nursing from an accredited school. If the applicant completes a program designed to prepare an advanced practice registered nurse on or after June 1, 2005, but before July 1, 2014, hold a master s or doctorate degree in nursing. If the applicant completes a program designed to prepare an advanced practice NOT FOR SALE registered OR nurse DISTRIBUTION on or after July 1, 2014: 1. Hold a master s or doctorate degree in nursing; and 2. Be certified as an advanced practice registered nurse by the American Board of Nursing Specialties, the National Commission for Certifying Agencies of the Institute for Credentialing Excellence or any other nationally recognized certification agency approved by the Board. Citation: Nev. Admin. Code New Hampshire Current Jones and & unencumbered Bartlett Learning, RN license from LLCNew Hampshire or a compact Jones state & Bartlett Le NOT Completion FOR of SALE an accredited OR DISTRIBUTION advanced nursing education program that NOT includes: FOR SALE OR D a. At least 225 hours of theoretical nursing content; and b. At least 480 hours of clinical nursing practice, including precepted experience and pharmacological interventions; Submission of a final, official transcript from a nurse practitioner program, Jones & Bartlett accredited Learning, by a national LLC accrediting body, that demonstrates Jones that the & Bartlett applicant Learning, LLC NOT FOR SALE earned OR a: DISTRIBUTION a. Graduate or post-masters graduate degree; or b. Certificate prior to July 1, 2004;..

21 Appendix 3-B 153 Documentation from the director of the program identified pursuant to (2) above for each pharmacology course taken but not reflected on the transcript, Jones verifying & Bartlett integration Learning, of pharmacological LLC interventions; NOT Evidence FOR of competence SALE OR to practice, DISTRIBUTION as a result of participation in and completion of the nurse practitioner program. The following, if the applicant graduated from an APRN program 2 or more years prior to the submission of the application: a. A copy of current national certification pursuant to Nur (a)(6); Jones & Bartlett b. Documentation Learning, of meeting LLC the advanced practice requirements Jones & set Bartlett forth in Learning, LLC NOT FOR SALE Nur OR (a)(6); DISTRIBUTION and c. Documentation of completion of the continuing education required pursuant to Nur (a)(7) including at least 5 hours in pharmacology, within the 2 years immediately preceding the application Citation: N.H. Code Jones Admin. & Bartlett R. Ann. [NUR] Learning, (b). LLC New Jersey Current New Jersey RN license in good standing Within two years prior to submitting an application, complete a master s degree in Jones nursing from & Bartlett a school accredited Learning, by a nursing LLC accrediting association recognized FOR by the SALE U.S. Department OR DISTRIBUTION of Education or a master s degree in nursing Jones & Bartlett Le NOT and completed a post-master s program that focuses on an advanced practice nursing specialty from a school accredited by a nursing accrediting association recognized by the U.S. Department of Education Completion of at least 39 hours in pharmacology Jones & Bartlett Completion Learning, of six contact LLChours in pharmacology related Jones to controlled & Bartlett dangerous substances, OR DISTRIBUTION including pharmacologic therapy and NOT addiction FOR prevention SALE and OR DISTRIBUTION Learning, LLC NOT FOR SALE management Pass an advanced practice examination in his/her area of specialty offered by a national certifying agency that is accredited by the American Board of Nursing Specialties and/or the National Commission for Certifying Agencies. Citation: N.J. Admin. Code tit. 13, 37: New Mexico Current, unencumbered RN license from New Mexico or a compact state Successful Jones completion & Bartlett of a Learning, master s degree LLC or higher in a nursing program designed FOR for the SALE education OR and DISTRIBUTION preparation of nurse practitioners as providers NOT of FOR SALE OR D Jones & Bartlett Le NOT primary, or acute, or chronic, or long-term, or end of life health care, offered through an accredited institution of higher education or through the armed services Applicants who do not hold a master s level or higher degree from a nurse practitioner Learning, program and were LLCinitially licensed by any board Jones before January & Bartlett 1, 2001, Learning, LLC Jones & Bartlett NOT FOR SALE must OR provide DISTRIBUTION verification of NP licensure National certification as a nurse practitioner Citation: N.M. Admin. Code A...